Provider Demographics
NPI:1164880191
Name:PIEROTTI, REBECCA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MARIE
Last Name:PIEROTTI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6361 THOMPSON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13206-1448
Mailing Address - Country:US
Mailing Address - Phone:570-401-6217
Mailing Address - Fax:
Practice Address - Street 1:6361 THOMPSON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13206-1448
Practice Address - Country:US
Practice Address - Phone:570-401-6217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX012799-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor